Cerebrovascular Disease 01

Topic: Adult

A formerly healthy 77 year-old male presents with a 2-week history of worsening dyspnea and weakness. Exam reveals numerous ulcerating lesions in the nares and oral mucosa. There is a left facial palsy and a right abducens palsy. There is weakness in knee flexion, knee extension, plantarflexion, and dorsiflexion on the left. Bloodwork reveals a high c-ANCA titer. Which of the following diagnoses is most likely?